Your Oral Health

Amalgam, Fluoride and More

The New Brunswick Dental Society understands that the most common questions patients ask about dentistry have to do with materials used to fix a cavity, infection control guidelines, community water fluoridation and dental X-rays.

In this section you will learn the true scientific facts about these important topics.
You should also feel confident in asking your dentist about important issues like these.

Want to do something good for your smile? If you live in one of the many New Brunswick communities that fluoridates its water, just head over to your sink and pour yourself a big glass of cold tap water.

With every glass of fluoridated water you drink, you’re getting a healthy dose of nature’s cavity fighter. In fact, it was proclaimed one of the ten great public health achievements of the 20th century by the Centers for Disease Control and Prevention.

Water fluoridation is simply the process of adjusting the natural level of fluoride in your water supply to an amount that will protect against tooth decay. A range of between 0.7 parts per million and 1.2 parts per million, depending upon the geographic area, has been determined to be the optimal amount to prevent dental decay.

Since its introduction, fluoridation has proven to be a simple, inexpensive, safe and effective way to dramatically reduce the rate of tooth decay in children and adults. In fact, water fluoridation can reduce the amount of decay in children’s teeth by as much as 60 percent and by nearly 35 percent in adults, providing a lifelong health benefit.

It also helps keep dental health costs down. It’s estimated that every dollar spent on fluoridation saves you more than $80 in preventive dental health costs.

So drink up. Your smile will thank you.

The last time you visited your dentist’s office, you probably noticed that the dentist, hygienist and assistant were wearing gloves, mask and eye protection. Perhaps you also noticed special coverings on the dental instruments and equipment.

These special safety precautions are called universal precautions and are used for every patient in the dental practice to prevent the transmission of any infectious diseases.

These precautions require all dental staff providing patient care to use appropriate protective wear such as gloves and, sometimes, masks and eyewear. After each patient visit, the gloves are discarded, hands are washed and a new pair of gloves is used for the next patient.

If you want to know how your dental office cleans and sterilizes its dental instruments, ask to see the sterilization room.

A lot of the sterilization and cleaning takes place before you enter the exam room. For example, all surfaces, including the dental chair, dental light, drawer handles and countertops, are thoroughly cleaned. Some offices may cover this equipment with protective covers, which are replaced after each patient.

Don’t let questions about safety keep you away from the dentist’s office, or cause stress while you’re there, when a short chat with your dentist can set your mind at ease.

Your dental health is too important to ignore. Remember to learn the facts about your dentist’s infection control procedures by talking with your dentist.

Checklist for Dental Patients

Your dentist cares about your health and well-being. Next time you visit your dentist, watch how each of the following procedures and items is handled:

  • Washing hands and changing gloves
  • Wearing protective clothing
  • Sterilizing and disinfecting instruments and equipment
  • Keeping the office spotlessly clean
  • Properly cleaning dental hand pieces
  • Using throwaway items
  • Proper disposal of waste

So you’re in the dental office and you need to have a cavity restored or a current filling replaced. What are your options?

Amalgam restorations, better known as “silver fillings,” is a term most of us have heard about. Dental amalgam is one of the most commonly used materials to fill cavities in decayed teeth. One of the reasons is that amalgam has a proven track record. It is widely used because it is durable and able to stand up to the intense pressure of chewing. For over 100 years, it has proven to be one of the safest, most effective and least expensive materials to fill a cavity.

These silver fillings are a mixture of silver, tin, copper and mercury. It’s the mercury that holds them together and makes them strong, hard and durable. In this form, the mercury is inactive and can’t hurt you. So even though very small amounts of mercury vapour are released when you chew or grind your teeth, there is no reason for alarm.

If you’re among the less than one percent of the population that is allergic to mercury, you may have an allergic response. If this is the case, symptoms, which are similar to common skin allergies, usually disappear within two to three weeks.

Typically, dental amalgam is used in children and adults for

  • Small-to-medium-sized cavities in the back teeth, including molars.
  • Teeth that absorb the intense stress and pressure from chewing.
  • As a foundation for cast-metal, metal-ceramic and ceramic restorations when patient cooperation during the procedure or commitment to oral hygiene is poor.

You and your dentist should decide the best method to restore a tooth, whether you are replacing a filling, repairing a damaged tooth or filling a tooth for the first time. Since cavities are usually smaller today, alternative materials are being used more often.

Here is a brief review of the some of the other materials available to repair your teeth. Be sure to talk with your dentist about which material is best for you.

Composites: Composites are made from synthetic resins and are used to make attractive restorations in the front teeth. Your dentist will use a combination of composites and sealants to treat small cavities and maintain the structure of the tooth.

Glass Ionomers: Glass ionomers were first used in the 1970s and they chemically bond to the tooth. One of the beneficial side effects is that they release fluoride, further protecting the teeth. Since glass ionomers are usually not used on biting surfaces, their use is limited to baby teeth and root surfaces.

Gold Foil: Gold foil is not widely used today, partly due to its relatively high cost. While these fillings may last 20 years or more, they are not used for large or very visible areas.

Cast Metal and Metal-Ceramic: These restorations are typically used for inlays, onlays, crowns and bridges. Cast metal and metal ceramic-restorations are most often used 1) in teeth damaged from the stress of chewing and biting; 2) when moderate to severe breakdown of the tooth requires replacement; and 3) if you require a more pleasing appearance than that of an amalgam.

So the next time you are faced with a decision about restoring a decayed tooth, be sure to talk with your dentist about the best way for you to keep smiling on.

In most cases, you only get X-rays when something hurts – like when you’ve sprained or broken something. So why does your dentist take X-rays when there’s nothing visibly wrong?

Basically, it’s because there are lots of things that can go wrong in your mouth in spaces your dentist just can’t see. Your dentist uses X-rays to get a detailed picture of the condition of your teeth, jaw, facial bones and the roots of your teeth.

With the help of X-rays, your dentist can often find and treat problems before they become serious, which ultimately saves you time and money. Some of the conditions your dentist can only see with the help of X-rays are:

  • small cavities between the teeth;
  • periodontal disease;
  • impacted teeth;
  • infections in the bone;
  • abscesses;
  • developmental abnormalities; and
  • certain growths, such as tumours and cysts.

Your dentist will set up a customized X-ray schedule for you using professional guidelines designed to keep your overall health in mind and based on your individual needs. A variety of factors including your age, risk for disease and signs and symptoms will also be taken into account. Children generally need more X-ray exams than adults because their teeth and jaws are still developing and because they’re more likely to fall victim to tooth decay.

As you probably know, dental X-rays involve a very low dose of radiation. This tiny dose of radiation is nothing for you to worry about, but your dentist takes special precautions to eliminate any safety risks. That’s why your dentist covers you with a lead apron. The dentist also uses high-speed film with equipment that restricts the beam to a specific area of the body, and even so, limits exposure.

Wondering why your dentist leaves the room every time an X-ray is taken? Basically it’s because if they didn’t, they’d be exposed to radiation several times every day. Over a long period of time, this would result in an unnecessary dose of radiation of no benefit to your dentist.

If you still have unanswered questions about X-ray exams, be sure to ask your dentist during your next visit. In the meantime, though, rest assured that everything is being done to protect the long-term health and safety of your beautiful smile.